Diabetes Mellitus and Health-Related Quality of Life Among Older Adults: Findings from the Behavioral Risk Factor Surveillance System (BRFSS)

Brown DW, Balluz LS, Giles WH, Beckles GL, Moriarty DG, Ford ES, Mokdad AH. Diabetes Res Clin Pract. 2004;65:105-115.

The purpose of this large, cross-sectional study was to examine the independent relationship between diabetes and health-related quality of life (HRQOL) in adults >50 years of age. Data from the Behavioral Risk Factor Surveillance System (BRFSS) were used, and HRQOL was assessed in participants with diabetes (n=37,054) using a reliable and valid measure developed by the Centers for Disease Control and Prevention.

Overall, older adults with diabetes were found to have poorer HRQOL than those without diabetes, independent of sociodemographic variables, duration of disease, treatment with insulin, body mass index, or comorbid cardiovascular disease. Older adults with diabetes reported almost 5 additional days of impaired health (physical or mental) and were 64% more likely to report ≥14 unhealthy days (physical or mental) over a 30-day period, compared with adults without diabetes. Older adults with diabetes had approximately twice the number of unhealthy days (physical or mental) as those without diabetes (10.1±0.32 days vs 5.7±0.43 days, respectively [mean±SE]) after adjusting for age. The relative odds of having ≥14 unhealthy days (physical or mental) in adults with diabetes, compared with people who do not have diabetes, was 1.64 (95% CI: 1.20, 2.23) after multivariate adjustment. Additionally, in adults with diabetes, the relative odds of having ≥14 unhealthy days (physical or mental) was 1.71-times greater in patients treated with insulin than those not treated with insulin (95% CI: 1.31, 2.22). Because this was a cross-sectional study, it should be noted that the results do not infer causality.

These findings are consistent with previous studies and highlight the need for care that encompasses not only the physical but the mental aspects of care in diabetes.